The Cholesterol Emboli Syndrome occurs when small cholesterol emboli that are dislodged from atheromatous lesions, usually within the aorta.


Demographics: reflect incidence of atherosclerosis:

(1) It is rare before the age of 50.

(2) Males are affected more often than females.

(3) Caucasians are affected more than Blacks.


While often following a catheterization or surgical procedures, it may occur independent of an inciting event. An inciting event may also have occurred weeks or even months before the patient presents.


Classic triad of features:

(1) livedo reticularis: reddish blue netlike mottling of the skin in the extremities

(2) acute renal failure

(3) eosinophilia


Additional findings:

(4) fever

(5) myalgia

(6) multiorgan involvement, based on the organs downstream from the site of embolization (in addition to skin and kidney: brain, eye, heart, intestines)


Histologic sections from an affected organ show cholesterol deposits within small arteries and arterioles.


Laboratory findings:

(1) elevated erythrocyte sedimentation rate (ESR)

(2) reduced serum complement

(3) modest proteinuria with or without hematuria


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